Which laboratory finding would most strongly indicate vascular calcification risk in CKD-MBD?

• A. Hypophosphatemia
• B. Normal phosphate
• C. Hyperphosphatemia
• D. Hyperkalemia

Answer: (C)

Elevated phosphate drives vascular calcification risk in CKD-MBD. When kidney function declines, phosphate isn’t cleared effectively, causing serum phosphate to rise. The higher the phosphate, the more the calcium–phosphate product can increase, leading to deposition of calcium phosphate in vascular walls. This process is a major contributor to vascular calcification in CKD, so a high phosphate level is the strongest laboratory signal of that risk.

Hypophosphatemia would be unusual in CKD and does not point to calcification risk. A normal phosphate level suggests average risk, while hyperkalemia reflects potassium disturbance, not mineral‑bone disorder–related calcification. In practice, the goal is to keep phosphate under control through diet and phosphate binders to reduce calcification risk.